Lorazepam

Oversedation is always the concern especially with parenteral administration and ensure facilities to resuscitate and manage airway are available

About: Always check the BNF link here

• Benzodiazepine

Mode of action

• Acts centrally and more prolonged than Diazepam

Indications

• Status epilepticus

Dose

• Status Epilepticus: Lorazepam 2-4 mg slow IV over 1 min into a large vein. Can be made up with 0.9% N-Saline and flush.
• Acute Agitation: Lorazepam 1-2 mg IV/IM. IM absorption is slower with sedation over 4-6 hrs.
• Anxiety/sedation: Lorazepam 1-2 mg BD PO/IM/IV ; 0.5-1 mg BD in elderly
• Insomnia associated with anxiety, 1-2 mg at bedtime;

Dose range:You must check with BNF or drug datasheet

Interactions

• Use a lower dose by 50% in patients taking sodium Valproate
• Effects are reversed by Flumazenil but risk of rebound seizure
• Caution with other sedative medications

Cautions

• Sedation and respiratory depression so have resuscitation equipment to hand

Contraindications

• Respiratory depression, unstable myasthenia, sleep apnoea, severe COPD, chronic psychosis, depression, muscle weakness

Side effects

• Respiratory depression, amnesia, drowsy, dependence, ataxia, headache, vertigo, hypotension, bradycardia

References

• Lorazepam in BNF